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Child Health Plan Plus (CHP+)

Child Health Plan Plus (CHP+) is public low-cost health insurance for certain children and pregnant women. It is for people who earn too much to qualify for Health First Colorado (Colorado's Medicaid Program), but not enough to pay for private health insurance.

In August 2016 there were 61,461 Coloradans enrolled in Child Health Plan Plus (CHP+).

Who Qualifies?

Children age 18 and under and pregnant women age 19 and over

Applicants with household income under 260% of the Federal Poverty Level (FPL). See the CHP+ Income Chart for details.

Colorado Residents

Lawfully residing children and pregnant women with no five year waiting period

What Does It Cost?

CHP+ costs vary depending on your household size and income. CHP+ members may have to pay an annual enrollment fee. This fee is due within 30 days of your CHP+ approval. If the enrollment fee is not paid within the 30 days allowed then the family will be denied and will need to re-apply. Some CHP+ clients may also have to pay co-payments to their health care provider at the time of service. Prenatal women, American Indians and Alaskan Natives do not have to pay annual enrollment fees or co-payments.

Fees & Co-Payments

Annual Enrollment Fees

The standard fees are:

$0 for an adult pregnant woman in the CHP+ Prenatal Care Program

$25 to enroll one child

$35 to enroll two or more children

American Indians and Alaskan Natives do not have to pay a fee

Families earning more than 214% of the Federal Poverty Level will pay higher fees (see the CHP+ Income Chart):

$75 to enroll one child

$105 to enroll two or more children

Co-Payments

You may also have to pay small co-payments when you or your child receives CHP+ services. There are no co-payments for preventative care, such as prenatal care and check-ups. Other services may require co-payments that vary based on your income. Native Americans and Alaskan Natives do not have to pay co-payments.

The chart below is a summary of copayments -- not an all-inclusive list.

Summary of Copayment Changes Effective October 1, 2013

Family Income (% FPL)

ER Visit

Urgent/After Hour

Ambulance/ER Transport

Inpatient Hospital

Physician Services at Hospital

Outpatient Hospital

Prescriptions

Lab/Imaging

< 101%

$3

$1

N/A

N/A

N/A

N/A

N/A

N/A

101-156%

$3

$1

$2

$2

$2

$2

$1

N/A

157-200%

$30

$20

$15

$20

$5

$5

$3-10

$5

201-260%

$50

$30

$25

$50

$10

$10

$5-15

$10

Out of Pocket Limit

Each year, the maximum amount of money (referred to as out-of-pocket limit) that you are required to spend on health care payments for all members of your household that are enrolled in CHP+ is 5% of your annual income. For more information about your out-of-pocket limit, please contact CHP+ customer service at 1-800-359-1991.

What if I'm pregnant now?

Who Qualifies?

Applicants with household income under 260% of the Federal Poverty Level (FPL). See the CHP+ Income Chart for details.

Colorado residents

Lawfully residing children and pregnant women with no five year waiting period

Applicants not eligible for Health First Colorado.

Applicants who do not have other health insurance

How much does the CHP+ Prenatal Care Program cost?

It is free to enroll in the CHP+ Prenatal Care Program. All pregnancy care is free, including prenatal care, labor and delivery, and visits after you deliver. Other medical care, such as prescriptions, may have small co-payments depending on your family size and income.

How long does CHP+ Prenatal Care Program coverage last?

If you are found eligible, your coverage will last for at least 60 days after your pregnancy ends. Coverage will end 60 days after the last day of the month when your pregnancy ended. For example, if you give birth on June 26th, your coverage will last until August 30th.

Will my newborn be enrolled in CHP+?

Once CHP+ is notified of your baby’s birth, your baby will be given CHP+ coverage for a full year from their date of birth. To enroll your newborn, call CHP+ Customer Service at (800) 359-1991.

Which doctors can I visit?

You may visit any of our prenatal providers. For medical care not related to your pregnancy, you may need to see a family health care provider. To find a CHP+ doctor or other provider see the CHP+ section of our Find a Doctor page.

What if I need immediate care for my pregnancy?

If you are pregnant, you may qualify for a program called Presumptive Eligibility (PE). PE is a way for pregnant women to receive prenatal care right away without having to wait to see if you are eligible. To apply, you must visit a PE Site and they will do a quick review. If found eligible you will get enrolled for up to 60 days while you wait to see if you qualify. Find a PE Site in your area.

Can I apply for CHP+ for my children and for the CHP+ Prenatal Care Program for myself?

Yes. Fill out one application. CHP+ will see if your children qualify for CHP+ and if you qualify for the CHP+ Prenatal Care Program.

Which doctors can I visit?

CHP+ works with Health Maintenance Organizations (HMOs) to provide medical care. Each HMO has their own network of doctors that your child can see on CHP+. The county you live in will determine which HMO your child enrolls with. If more than one HMO is available in your county, you must select an HMO.

CHP+ Health Maintenance Organizations (HMOs)

CHP+ members have the option of joining a Health Maintenance Organization (HMO). An HMO is an organized system that provides a wide range of health care services including Primary Care Providers (PCP) to manage your health care needs. Each HMO uses different hospitals, pharmacies and doctors for the counties it serves.

For those clients that are part of or applying for CHP+ Prenatal benefits, Presumptive Eligibility, or reside in El Paso, Sedgwick or Teller counties please refer to the State Managed Care Network information below.

To find a CHP+ doctor or other provider see the CHP+ section of our Find a Doctor page.

How do I get dental benefits?

Delta Dental of Colorado provides dental benefits to all eligible and enrolled CHP+ child members. These benefits include preventive and diagnostic services, restorative services, endodontic, periodontic, prosthodontic, oral surgery, and limited orthodontic services. There will be a maximum allowable of $1000.00 per child per calendar year (January 1 - December 31). As with all CHP+ benefits, higher income families may be required to pay a small fee when they receive services. If you have any questions about CHP+ dental benefits call Delta Dental at 1-800-610-0201​.

Who do I call if I have questions about my benefits?

What if I need a new membership card?

To get a new membership card, contact your CHP+ Health Maintenance Organization (HMO).

How long does CHP+ coverage last?

For children, CHP+ coverage begins the date the application is received at the CHP+ office, an Application Assistance Site, or a county office. Coverage lasts at least 12 months.

For pregnant women, CHP+ Prenatal Care Program coverage begins the date the application is received at the CHP+ office, an Application Assistance Site, or a county office. Coverage ends 60 days after the last day of the month your pregnancy ends.

How do I renew CHP+ coverage?

Children enrolled in CHP+ must reapply every year. CHP+ will send you a packet about 3 months before your child’s coverage ends. Complete this and return it to CHP+ as soon as possible. If you do not receive a renewal packet, call CHP+ Customer Service at (800) 359-1991 to ask for one.

Clients who have an active PEAK account will also have the ability to pay enrollment fees and update their information at any time.

Pregnant women enrolled in the CHP+ Prenatal Care Program cannot renew coverage after their pregnancy ends. If you do become pregnant again, however, you can apply again.

Can I enroll my newborn baby?

Call CHP+ Customer Service at (800) 359-1991 to see if your baby qualifies for CHP+.

What if I move?

Call us and tell us your new address as soon as you move. CHP+ sends letters to families letting them know about their benefits, so it is very important that we have a correct address. If you move out of state, you no longer qualify for CHP+ benefits. To find programs in other states, visit insurekidsnow.gov.

What if I get a bill from the doctor?

Your CHP+ Health Maintenance Organization (HMO) can help you get medical bills paid.

How can I apply?

When will I find out if I qualify?

If you apply online through PEAK you may find out if you qualify immediately. If you apply by mail, it may take up to 45 days to find out if you qualify.

What if I need immediate care?

You may qualify for a program called Presumptive Eligibility (PE). PE is a way for children and pregnant women to receive care right away without having to wait to see if you are eligible. To apply, you must visit a PE Site and they will do a quick review. If found eligible you will get enrolled for up to 60 days while you wait to see if you qualify. Find a PE Site in your area.